Granulomatosis with polyangiitis (GPA) is a rare systemic disease characterized by two parallel processes: necrotizing granulomatous inflammation and low-immune vasculitis predominantly affecting small vessels. Differential diagnosis of lung lesions on CT in patients with an established diagnosis of granulomatosis with polyangiitis can be very difficult.Purpose. Developing computed tomography criteria for the differential diagnosis of infiltrative changes in the lungs in patients with GPA and community-acquired bacterial pneumonia.Materials and methods. 67 CT examinations of the chest by 24 patients with verified GPA with infiltrative lung lesions and 36 CT examinations by 30 patients with bacterial pneumonia without concomitant pulmonary pathology, a comparative analysis of the following characteristics of ground glass opacity symptom was performed: “location", “craniocaudal distribution”, “uniformity”, “localization”, “quantity”, “association with consolidation”, “association with pleural effusion”. CT was performed natively on a Toshiba Aquilion Prime CT scanner according to a standard examination protocol with a slice thickness of 1 mm. Statistical processing of the obtained results was carried outusing the software application RStudio, version 1.3.1093 for mac OS (RStudio, PBC). To study the relationships between two categorical variables, the χ2 independence test and the principal component method for categoricalvariables were used.Results. GPA is characterized by multiple bilateral areas of ground glass opacity compaction, often with a central location, without a statistically significant craniocaudal dependence in the lung regions. In community-acquired pneumonia, this sign is more likely to be unilateral with a peripheral location in the lower lobes of the lung. Statistically significant differences in the degree of homogeneity, combination with consolidation, pleural effusion have not been established.Conclusion. CT reveals the characteristic features of the ground glass opacity CT sign in GPA and pneumonia, which, together with clinical and laboratory data, increase the accuracy of radiodiagnosis of these diseases.

Aim: to analize computed tomography data while planning autotransplantation of the liver for advanced alveococcosis.Materials and Methods.A retrospective analysis of the results of multidetector computed tomography of the abdomen and retroperitoneal space of 7 patients with advanced liver alveococcosis was made in order to plan autotransplantation. Besides a description of the location and size of parasitic lesion for each patient relationship with main vessels was evaluated - the inferior vena cava, hepatic and portal veins, hepatic arteries, and the presence of extrahepatic component. The vessel assessed as involved in the pathological process not only in case of clear invasion, but also with abutment because of infiltrative growth of alveococcus. The accuracy of the method was estimated by comparison with the intraoperative data.Results.The data of computed tomography while the planning of liver autotransplantation coincided with the intraoperative data in all examined patients. The main criteria indicating the need for this type of surgical intervention was the involvement of the retrohepatic part of the inferior vena cava to the caval gates inclusive and/or hepatic veins. With extrahepatic spread of parasitic masses it is possible to affect not only the surrounding organs, but also the main vessels, for example, with growth in the hepatic-duodenal ligament. Thus, in one patient during the operation, the occlusion of artery hepatica propria was confirmed. In two cases of recurrence of the parasitic process after rightsided hemihepatectomy, the almost identical pattern of involvement of the liver resection surface, inferior cava and portal veins, diaphragm, adrenal gland in combination with a extent adhesive process in the right subdiaphragmal space.Conclusions.CT scan data allowed to correctly plan the volume of operative intervention – autotransplantation of the liver – in all the examined patients. It is of interest to evaluate the accuracy of the method on a larger group of patients.

Granulomatosis with polyangiitis (GPA) (Wegener's granulomatosis) is a rare systemic autoimmune disease from the group of vasculitis associated with anti-neutrophil cytoplasmic antibodies (ANCAs). GPA is proceeding with granulomatous inflammation, mainly of the upper and lower respiratory tract and low-immune necrotizing vasculitis that affects small- and medium-size vessels in lungs, kidneys, skin. The disease is an extremely rare long-term systemic disorder, is rarely the object of research, the literature data are few and unsystematic.Purpose. The purpose of the literature review was to study the published materials, analyze the received information and define tasks for further study of this pathology, primarily from the standpoint of radiation diagnostics.Materials and methods. The search was carried out in bibliographic databases MedLine, PubMed, if necessary, links to external full-text sources were used. 36 of the most significant publications were selected and worked out, including 8 domestic and 28 foreign. One of the selection criteria for articles was the availability of information about the radiological diagnosis of GPA in them.Results. Most authors focus their attention on clinical manifestations and features of treatment, not paying sufficient attention to diagnostic methods. Many studies have been carried out on a small sample of patients or are limited to individual clinical observations; there is practically no information on changes in the computed tomographic picture of the lungs in GPA in dynamics. The most complete semiotics of lung damage according to CT data is presented in the article by F. Martinez et al. (2012).Conclusions. It was found that in case of lung lesions by GPA, nodules, nodes and masses are more often determined, in half of cases – with cavities of decay, less often areas of ground-glass opacity and consolidation are detected. However, at present there is no unified approach to the interpretation of the radiological semiotics of the disease and the determination of the diagnostic value of individual computed tomographic patterns of lung damage. This requires their further detailed study for the correct and timely diagnosis of such a rare, but complex and potentially life-threatening disease.